Medicare 2026

Does Medicare Cover Ozempic, Wegovy, Mounjaro and Zepbound? It Depends on Why You Take It

GLP-1 drugs have become some of the most talked-about medications in the country. If you have Medicare, the question isn't really whether these drugs are "covered" — it's why your doctor is prescribing them. The answer to that question changes everything about what Medicare will pay for.

The rule that drives everything: why you're taking it

By federal law, Medicare Part D is not allowed to cover drugs used for weight loss alone. That single rule explains most of the confusion around Ozempic, Wegovy, Mounjaro and Zepbound.

What Part D can cover is a GLP-1 drug prescribed for a medically accepted use other than weight loss. Here is where each of the familiar names stands:

• Ozempic, Rybelsus, Mounjaro and Trulicity are approved to treat type 2 diabetes. A Part D plan can cover them for that purpose.
• Wegovy is also approved to lower the risk of heart attack and stroke in adults who have heart disease and either obesity or overweight. For that use, Part D plans can cover it.
• Zepbound is also approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity. For that use, Part D plans can cover it.

In every case, the plan's formulary and utilization rules apply. Prior authorization is common — the plan may require your prescriber to document the diagnosis and that the drug is being used for the approved condition, not for weight loss alone.

The new piece: the Medicare GLP-1 Bridge

For people who are being prescribed a GLP-1 drug specifically for weight loss, Medicare has set up a temporary program called the Medicare GLP-1 Bridge. It is a CMS demonstration that runs outside your Part D plan, from July 1, 2026 through December 31, 2027.

Here is how it works:

• Drugs covered: Wegovy (injection or tablet), Zepbound KwikPen only (not single-dose vials or pens), and Foundayo (a tablet).
• Cost: You pay a flat $50 copay at the pharmacy for a one-month supply (28 or 30 days). The Bridge does not fill 60- or 90-day supplies.
• Your Part D deductible does not apply, and the $50 you pay does not count toward your Part D deductible or your Part D out-of-pocket cap.

The Bridge is designed for people whose only reason for the prescription is weight loss. You are not eligible for the Bridge if you already receive a GLP-1 through your Part D plan, or if you have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease. In those situations, your Medicare drug plan — not the Bridge — is where coverage should come from.

What your out-of-pocket cost looks like under Part D

When a GLP-1 drug is covered by Part D for an approved use, standard Part D cost-sharing applies. For 2027, two numbers are worth knowing:

• The Part D out-of-pocket cap is $2,400 in 2027 (it is $2,100 in 2026). Once your out-of-pocket spending on covered drugs reaches that cap in a calendar year, you pay $0 for the rest of the year on covered drugs.
• The most any Part D plan may charge as a deductible in 2027 is $700. Plans can set a lower deductible or none at all.

Medicare also negotiated prices on several high-cost drugs. Starting January 1, 2027, Ozempic, Rybelsus and Wegovy have a Medicare negotiated price of $274 for a 30-day supply (compared with a list price of $959 in 2024). That negotiated price affects what plans pay; what you pay at the counter still depends on your plan's cost-sharing rules.

For reference, the Part D base beneficiary premium for 2027 is $41.33. That is a national figure used to calculate the late-enrollment penalty; the premium you actually pay is set plan by plan.

The 2027 Part B standard premium, Part B deductible, and the income-related (IRMAA) brackets have not yet been announced. CMS announces those figures in the fall, usually in November. Check Medicare.gov for the official numbers once they are posted.

When you can make changes

Annual Enrollment for 2027 coverage runs October 15 – December 7, 2026, with choices taking effect January 1, 2027. This is the main window to compare Part D plans, including how each plan covers the specific GLP-1 drug you take.

If you have Medicaid or Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated D-SNP in any month.

Original Medicare + Medigap vs. Medicare Advantage

Prescription drug coverage comes through Part D either way, but the overall structure differs. Original Medicare with a Medigap policy and a stand-alone Part D plan generally offers broad provider access nationwide and predictable supplemental cost-sharing, with separate premiums for Medigap and Part D. Medicare Advantage plans bundle hospital, medical, and usually drug coverage into one plan, often with extra benefits, but with network and prior-authorization rules set by the plan. Neither is "better" — the right fit depends on your doctors, your drugs (including any GLP-1 you take), your budget, and how you like to get care.

Where to go next

For official information, drug-pricing lookups, and plan comparisons, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week. If you've been prescribed a GLP-1 drug, bring the exact name, dose, and the condition it's being prescribed for — that is the information that determines how Medicare covers it.